Rituximab Plus Combination Chemotherapy in Treating Patients With HIV-Related Non-Hodgkin's Lymphoma

RATIONALE: Monoclonal antibodies such as rituximab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining rituximab with chemotherapy may kill more cancer cells. PURPOSE: Phase I trial to study the effectiveness of rituximab plus combination chemotherapy in treating patients who have HIV-related non-Hodgkin's lymphoma.

OBJECTIVES: Determine the response rate of patients with poor-prognosis, HIV-related non-Hodgkin's lymphoma treated with rituximab combined with prednisolone, vincristine, and bleomycin. Determine the toxicity of this regimen in these patients. Determine the time to progression and survival of patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive chemotherapy comprising vincristine IV and bleomycin IV on day 1 and oral prednisolone every other day beginning on day 1. Treatment repeats every 3 weeks for 6 courses. Patients also receive rituximab on days 14, 21, 28, and 35. Patients who achieve complete response (CR) receive 2 additional courses of chemotherapy after CR. Patients are followed every 1-2 months. PROJECTED ACCRUAL: A total of 10-20 patients will be accrued for this study.

AIDS-related peripheral/systemic lymphoma, AIDS-related diffuse large cell lymphoma, AIDS-related immunoblastic large cell lymphoma, AIDS-related small noncleaved cell lymphoma, AIDS-related diffuse mixed cell lymphoma, AIDS-related diffuse small cleaved cell lymphoma, AIDS-related lymphoblastic lymphoma

DISEASE CHARACTERISTICS: Diagnosis of poor-prognosis, HIV-related non-Hodgkin's lymphoma (HIV-NHL) Previously untreated More than 1 of the following criteria: Prior diagnosis of AIDS ECOG performance status 3-4 CD4 count less than 100/mm3 No primary cerebral lymphoma PATIENT CHARACTERISTICS: Age: 18 and over Performance status: See Disease Characteristics Life expectancy: Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior chemotherapy for HIV-NHL At least 1 year since prior chemotherapy for Kaposi's sarcoma (KS) Endocrine therapy: Not specified Radiotherapy: Prior radiotherapy for HIV-NHL allowed At least 1 year since prior radiotherapy for KS Surgery: Not specified